Non-Sports Related Concussions

Regardless of age and profession, motor vehicle accidents and falls are the most common ways that people can sustain traumatic brain injuries. Even first responders – police, fire, and ambulance crews – regularly go into harm’s way and risk personal injury that includes concussions, as recently happened when two firefighters in New Jersey slipped while jumping off their fire engine at a house fire.

Even firefighters and other first responders are vulnerable to concussions (Photo: AP/Wide World)

Although sports like football, soccer, and lacrosse get a majority of the press about head traumas and traumatic brain injuries, most of the traumatic brain injuries that we see in HeadFirst Concussion clinics are due to everyday events such as slips and falls and motor vehicle accidents.

Some doctors tell me that the “concussion craze” is going to burn out soon. However, I think the way concussion specialists and medical providers diagnosis and treat traumatic brain injuries will continue to evolve. Other clinicians believe that education, evaluation and treatment of mTBIs will continue to grow in different directions.

Some considerations for the future may include:
– people who carry weapons, work with hazardous materials, or are employed in high-risk jobs could require baseline neurocognitive testing with their employment physical in the event they suffer a brain injury
– schoolchildren of all ages, including the elementary school level, may receive education, baseline testing, while training may be required for all parents and coaches about traumatic brain injuries (it is presently only required for high school kids)
– employers may insist employees to get baseline neurocognitive testing prior as a condition of employment

What we have found in HeadFirst Concussion clinics is that 60-70% of mTBIs are not sports related and more than 95% of our injured patients have not had baseline neurocognitive testing. While concussions continue to make the news and diagnosis increase as public awareness spreads, we encourage people of all ages to schedule a baseline neurocognitive test.

Basic physics teaches us that an object at rest will always remain at rest unless acted on by an unbalanced force. Likewise, an object in motion will continue in motion with the same speed and in the same direction unless acted upon by an unbalanced force. We humans are objects that seem to always be always in motion, so it stands to reason that we’re continually acted upon by external forces that change our direction. Unfortunately, the direction that these forces sometimes push us coincides with another of Newton’s Laws: Gravity.

Slips and falls are one of the top causes of unintentional injuries in the United States, accounting for approximately 8.9 million visits to the emergency department annually (National Safety Council Injury Facts 2011). When we fall, it always seems like we fall head first. Falling out of bed, slipping in the bath, falling down steps, and falling from ladders accounts for a large percentage of head traumas, some of which can result in Mild Traumatic Brain Injuries (MTBI).

Since becoming an object perpetually at rest is not an option lowering the impact of these unbalanced forces is the only way we can prevent these traumatic injuries from occurring. Fortunately with spring in the air now is a good time clean up our homes (where most of these injuries occur) to prevent these injuries from happening.

Here are some home safety tips to help prevent injuries and falls:

o Clean up all spills immediately

o Stay off freshly mopped floors

o Secure electrical and phone cords out of traffic areas

o Remove small throw rugs or use non-skid mats to keep them from slipping

Editor’s Note: Following is a first-hand account from HeadFirst Concussion Care Provider Sherray Holland, PA-C (pictured below), about her own experience with brain trauma while engaged in the most routine of activities — grocery shopping.

I want to start off and say that this is a subject near and dear to my heart. I have worked with concussion patients since 2008. According to the Centers for Disease Control and Prevention (CDC), at least 1.7 million people in the United States sustain a concussion each year and seek help, but we believe this number is actually doubled because so many people still do not get checked out.

When I was younger (I am in my mid 30s now!), I was told to “shake it off” and keep playing or not go to sleep after hitting my head. Sound familiar?! So much has changed since those days as more education and research has been done about concussion. However, I think we still have that mentality when it comes to ourselves and we end up trying to push hard through the pain.

Now, I would like to share my story. A few years ago, I was texting and walking into a store in a shopping center. As I stepped onto the curb, my shoe got stuck and I tripped! I could not gain control (picture my arms flailing and trying to stand). Then I suddenly realize I was going to fall…and hard. I kept thinking, “This is going to hurt.” My next memory was lying face up with a few people looking down at me in panic. I remember being upset because an older man said “Boy that was a bad fall, are you okay?” Embarrassed, I thanked everyone, dusted myself off, grabbed my boot (which came off) and took my purse. My head hurt but I went in anyway to get a few items. I figured “Hey, I work with brain injuries so I will check myself out later.”

You can imagine my annoyance when I was stopped by a security officer. He said, “Ma’am, are you ok?” Frustrated, I said, “Why is everyone so concerned, I just fell!” The next few words have always stuck in my head. He replied, “You may want to get checked out, I can call for help. You have been wandering the store for two hours.” I rolled my eyes but I caught a glimpse of myself in a mirror. I was in shock! I was bleeding down my head, onto my face. I saw cuts and bruising to my forehead and left cheek. My knee was bleeding through my jeans. I was a mess! I ran out of the store, leaving my empty cart.

I went home and cleaned myself up. I figured since I was a medical professional, I could treat myself. I knew I needed to rest. I took medication for my headache. I took the next couple days off and slept. I returned to work full-time and cared for my infant son as usual.

Easy peasy, right? Wrong! I struggled tremendously, especially with my memory. I could not remember anything: What a patient asked me two minutes ago; what my supervisor just told me to do; what I read in a chart or typed on the computer, not to mention at home with my son and family. I had headaches from trying to think too hard. I was so tired all the time. I was emotional and frustrated because I could not do it all anymore!

Finally, I gave in. I confided to my supervisor and doctor because I wasn’t getting better. They echoed what I already knew: RELAX. REST. WRITE THINGS DOWN, etc. Once I cut back my hours, gradually went back to work and did not stress about things at work or my life I immediately saw improvements. It took me longer because I did not want to slow down but I am fully recovered.

Here is the bottom line: If you have been seen and told you have a concussion, please do the brain rest and gradually go back to the activities, whether it is work, school or sports or all of the above. Trust me, I’ve been there. I wanted to go back to my regular activities immediately but it simply is not the way to go. You will NOT be giving yourself a fair shot if your brain does not have the time to heal completely.

Think of your brain like a sprained ankle for a second. You would not want to hurry and start walking on it right away. I think we forget how important it is because we cannot see the brain injury. Recovery time can vary and depends on other things such as your past medical history, symptoms, etc. But the sooner you seek help and follow the guidance of your provider, the sooner you will improve!

Know the signs and symptoms of concussion. If you or someone you know has had a head injury and is not getting better, please contact HeadFirst Concussion Care at 855-SIT IT OUT (748-4868) to speak with someone and/or set up an appointment for an evaluation. Visit myHeadFirst.com for more information on concussion.

Thank you for allowing me to share my story, and I would love to hear yours.